Provider Demographics
NPI:1457497752
Name:BAYLERAN, EDWARD DANIEL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:DANIEL
Last Name:BAYLERAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:31370 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4356
Mailing Address - Country:US
Mailing Address - Phone:248-645-5340
Mailing Address - Fax:248-645-0928
Practice Address - Street 1:31370 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4356
Practice Address - Country:US
Practice Address - Phone:248-645-5340
Practice Address - Fax:248-645-0928
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI094871223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics